End Water Poverty is the international campaign that aims to bring an end to the global water and sanitation crisis.
We are formed of organisations from around the world, demanding urgent action and leadership from donors and governments alike.
Only together, with one voice, can we tackle this devastating crisis that affects billions of poor people across the world.
Read our blog for the latest news on water and sanitation advocacy and join us on www.endwaterpoverty.org too.

Friday, 14 September 2012

Martin Carroll, Deputy Head of the International Department at the British Medical Association, highlights the importance of healthcare information in the post-2015 agenda.

Clean, safe and available: three words which neatly sum up
End Water Poverty’s vision. Clean water which does not carry life-threatening
disease, safe sanitation which does not make water dirty, and both of these
universally available. Earlier this year, a major step was made towards
realising the vision. UNICEF and WHO
announced that the Millennium Development Goal (MDG) target to halve the
proportion of people without sustainable access to safe drinking water had been
achieved, well in advance of the 2015 deadline.

UNICEF claimed that the gains made demonstrated that MDG
targets could be met with will, effort and funds. But it also acknowledged that
the most difficult work lay ahead. 11% of the global population – 783 million
people – are still without access to clean, safe drinking water and billions
more have no sanitation facilities.

The post-2015 landscape offers the chance to develop a more
inclusive and participative framework which can foster innovative and
integrated approaches like those described in “Join Up, Scale Up”, a collection
of case studies, published in 2011 by a group of six influential aid agencies,
including EWP. The ‘interconnected’ nature of the MDGs has long been
acknowledged: “Join up, Scale Up” showed how it could work in practice, with
water, sanitation, nutrition, and education programs connecting and
collaborating in a variety of combinations to achieve tangible results. The
advantage of the integrated approach is that it can be adapted to suit a range
of collaborations with other sectors and campaigns. Healthcare Information forAll by 2015 (HIFA2015) – of which End Water Poverty is already a member - is a
prime example.

Like clean and safe water, the availability of relevant and
reliable healthcare information is fundamental for health.Yet thousands of children, men and women die
needlessly every day because their parent, caregiver or health professional did
not know what to do or where to seek help.

Childhood diarrhoea, the biggest killer of children
worldwide and frequently the result of unclean water and poor sanitation, is
one area where ‘information poverty’ has a particularly significant impact.
Evidence from India shows that 4 in 10 mothers believe that fluids should be withheld
when their child develops diarrhoea, thereby tragically contributing to the
risk of death of their own children; 1000 children are dying every day - in
India alone - due to dehydration associated with diarrhoea. More than 90% of
these lives could have been saved with basic life-saving interventions that are
locally available but simply not provided due largely to lack of basic
healthcare knowledge. HIFA2015 members report similar problems in Africa and
other LMICs.

It is a typical example of a wider problem which HIFA2015 is
addressing: healthcare providers’ information and learning needs are not being
met. HIFA2015 is working to harness the experiential knowledge of its
membership - 8000 individuals from 2000 organisations in 167 countries
worldwide – to determine what those needs are, the barriers and drivers to
meeting them and how to improve availability of relevant and reliable
healthcare information in low- and middle-income countries. At the heart of the
network is a group of solution-focused email forums in English, French and Portuguese,
in collaboration with the BMA, WHO and many other health and development
organisations. As I write this, a discussion is taking place on the main
HIFA2015 forum about public understanding of the links between water and
disease, and ways to promote and scale up effective solutions such as solar
water disinfection, a simple procedure to disinfect drinking water, using
UV-radiation to kill diarrhoea-generating pathogens. Join here: www.hifa2015.org

The potential for HIFA2015 and End Water Poverty to
integrate efforts and break the vicious cycle which claims the lives of
thousands of children every day is clear. Success in meeting the challenges of
the post-2015 world will depend upon the willingness of governments to provide
political and financial support for powerful alliances like these.

Yakub Hossain
is the Deputy Executive Director of Village Education Resource Center (VERC) - a national NGO in Bangladesh, and the National Convenor
of Fresh Water Action Network South Asia (FANSA) Bangladesh Chapter.

On the whole, the MDGs have been partly
successful in Bangladesh.
The water and sanitation situation has improved as
an outcome of local and global initiatives, however, current progress rates on achieving the
sanitation target is only 1.1% per year, yet in order to meet the target, we
need 4% progress rates per year. At these rates, the WHO calculates that it will take
until 2033 to reach the MDG target - this is not good enough. A recent
WHO report also stated that the financial flows at both national and local
government levels are less than 75% of needs as required for meeting the MDG
targets.

The lack of funding for the Least Developed
Countries, especially in Africa and South Asia,
has been a big problem with the MDGs. Also, governments have not always used funds smartly, and there is a need for a more collaborative monitoring process in place.

We need a revised action plan in order to
make progress with global development. One important issue which should be
addressed in the new development framework is proper evidence of progress,
certified by an international body. The national governments also need to
be answerable to their people, and to the donor communities.

Another key area which needs to be
addressed by the new development framework is to prioritize the countries
that are lagging behind - they should be given more attention. Countries
in South Asia such as Bangladesh have big needs - it is not just countries
in Africa which need to be given greater priority.

In terms of
sanitation and water, we definitely need a global goal to address them - without a clear global goal, we
won't be free from the water and sanitation crisis.

The decision-making process for the new
development framework should involve all the stakeholders, including the local
people. My organisation, the Village Education Resource Center (VERC), has a good relationship with the government, and we use the mechanism of a
forum with the highest body in the Ministry to communicate our views. At the
country-level, government, civil society, and UN institutions should work
together - civil society especially is a vital part of the development process.

Joanna Hoffman is Special Projects Manager at Women Deliver, a global advocacy organization bringing together voices from around the world to call for action to improve the health and well-being of girls and women. In this post sheexplains why women and girls must be at the centre of the post-2015 process, and invites you to join the Women Deliver global conference in 2013.

In just a few years, key international
agreements such as the Millennium Development Goals (MDGs) and the International
Conference on Population and Development’s (ICPD) Programme of Action will
expire. Opinions about what will come next are mixed: some believe all health
issues—including maternal health, child health, and HIV/AIDS—will be collapsed
into one objective; others believe the MDGs should be extended; and others
believe an entirely new framework will shape the path forward.

Regardless of what is chosen, we are sure
of one thing—girls and women must be at the center of development in 2015 and
beyond. More than 215 million women still have an unmet need for modern contraceptives and
287,000 women around the globe die each year from complications arising in
pregnancy and childbirth. Most of these deaths occur in developing countries
and are entirely preventable.

Safe drinking water is a proven,
life-saving solution to preventing maternal deaths, yet still at least 783
million people around the world lack access. Sepsis accounts for 15% of
maternal deaths in developing countries. Contact with unsafe water can
result in a wide range of bacteria, viruses, and parasites which can weaken
pregnant women’s immune systems, leading to potentially fatal complications.

Girls and women are the ones most affected
by unsafe water, and by nearly all development challenges. Moving forward, it
will be increasingly important to recognize the linkages between
girls, women, and all development areas. Girls and women form the majority of
the world’s poor and illiterate. In Africa, they account for 75% of those
living with HIV/AIDS. They are also those most affected by toxic cooking fumes.

Given these areas of intersection, it’s
important that we now begin to work together across sectors, development
fields, and the globe. Tackling the greatest obstacles to human and sustainable
development require all hands on deck.

Saving women’s lives is not only the right
thing to do, it’s also the smart
thing to do. Healthy mothers are more likely to have healthy, educated children.
More of their income goes to food, medicine, and other family needs, and their
unpaid labor contributes up to one-third of global Gross Domestic Product
(GDP). In short, when girls and women win, we all win.

In an effort to mobilize strategic partnerships
and bring the best and brightest minds together to save the lives of girls and
women, Women Deliver is holding a third global
conference this May in Kuala Lumpur, Malaysia. We will gather over 5,000
civil society advocates, researchers, Ministers, journalists, Parliamentarians,
private sector executives, and youth activists to call on world leaders to
prioritize girls and women in 2015 and beyond. The conference will feature over
120 breakout sessions, high-level speakers, and a full day dedicated to
discussion on the post-MDG framework.

I hope you will consider joining us in
Kuala Lumpur. Together, we will put the world on notice that girls and women
are at the heart of development. They are, in every sense, the future of our
world.

There is a scene in the film “The Great Escape” where
Steve McQueen and Angus Lennie decide to escape from the prison camp by digging
their way to freedom overnight. They achieve speed by simply burrowing like
moles, filling in the tunnel behind them as they move forward. They don’t
bother worrying about building the support structure behindthem to ensure that the tunnel doesn’t
collapse because that would slow them down in achieving their goal; freedom.

You may have guessed where this
tenuous analogy is leading.

There are many criticisms of the
MDGs, especially when it comes to their prioritisation of water, sanitation
(which didn’t even make an appearance in the original draft) and hygiene (which
still isn’t specified, despite it being one of the most important public health
interventions), but it is worth giving them credit for making the international
community strive towards a goal.

Unfortunately, in terms of water
and sanitation, the pursuit of that goal has been all too similar to that of
McQueen and Lennie; we have made achieving the goal our priority, without
giving enough thought to whether a solid tunnel remains intact to allow others
to use it.

The UN-WHO JMP report which makes
the claim that we have hit the “water target” also concedes that this doesn’t
take into account the functionality or the water quality of protected sources and
rightly notes that sanitation is well off track. So we’ve achieved the MDG in
theory, but in practice?We questioned
this assertion but our voice is small. Then Ned Breslin, CEO of Water for
People, brought his guns to bear and shot
gaping holes in the JMP report, citing surveys of functionality in
Mozambique.

However, this is not an exercise
in stone throwing. We all want to achieve full, sustainable coverage. We want
to have full, sustainable access to safe drinking water, sanitation and
hygiene.

The Busoga Trust is a small organisation
but an experienced one and we have learnt many lessons. Learnt, more often than
not, through our mistakes and the mistakes of others. We have constructed a lot
of water sources in that time, but a few years ago we realised that we could
not be sure how many were still functional. This was an unacceptable situation
in our eyes, though one which partly as a result of being at the mercy of donor
priorities. We resolved to ensure that 100% of our sources are functional and
now 50% of our monthly workload is in carrying out rehabilitations. Our
strategy, is to look to the past, present and future of our work in Uganda;

Present:Reinstate our
comprehensive long term monitoring, evaluation and maintenance system.

Future: Continue to
provide water sources to communities but only as one part of an integrated
intervention where sanitation and hygiene come first.

So the question which this whole
article has been gearing up to ask in a circuitous way is;“What would we like to see in the successor to the MDGs?”

Leaving aside the issue of
greater prioritisation of WASH within the MDGs/successor, because we assume
this will be argued for by many others in this blog series, we would like any future MDGsto contain a clear and distinct provision for
accurate reporting of coverage levels and consolidation of the work carried out
in the last 15 years.

We do not want the international
community to pat itself on the back in 2015 on a job well done without first
checking that the job has actually been done. Is the provision sustainable? Are
pumps working? Is open defecation still polluting water from safe sources? Are
aquifers being drained to serve a short term economic purpose?

We found this derelict well on a village survey - the villagers had actually gone back to taking water from the traditional source. The well had only been installed about 3 years previously.

This should happen across the
board, not just in the WASH sector; are DOTS programmes for TB experiencing
full participation? Are cases of malaria being properly diagnosed and if so, is
the full course of treatment being adhered to? If skilled birth attendants are
trained and employed, are the transport logistics in place to actually get them
to patients?

Children drinking from one of our newly installed pumps in rural Uganda.

In the WASH sector, such work is
already happening; in Uganda the Ministry of Water & Environment has
produced the Water
Atlas, a comprehensive mapping exercise detailing every rural water point
and functionality levels. They also record reasons for water point failure. The
question is whether that data can be kept current. The organisation Water for
People also launched a macro-reporting concept model at World Water Week in
Stockholm, pithily entitled “Reimagining
Reporting”.

Our point is that any successor
to the MDGs ought to pursue accurate reporting and integrity of information as
a goal in itself. Governments should be supported in developing their
monitoring capacity, rather than purely chasing the donor dollar down
unsustainable avenues.

I doubt consolidation or
monitoring is as easy to sell as a set of aspirational targets, but if we fail
to do this then that tunnel will collapse behind us and the whole exercise of
the MDGs will need repeating by successive generations.